Christine Montross, a resident in psychiatry at Brown University wrote in an Op-Ed piece in The New York Times that "many medical schools are beginning to argue that imaging technology has improved to the point where it should be used in place of the dissection of human cadavers as the central tool of instruction for young doctors-to-be. However, she believes that this is a mistake. She says that no matter how detailed and versatile they become, computer images can never provide the indelible lessons that novice doctors learn from real bodies." As medical students progress through their years of higher education, the introduction of patients can come abruptly. Whether they recognize it or not, the cadaver they meet in their Anatomy Class is truly their very first 'patient as teacher' whom they will get to know in great detail. To highlight this fact, Lisa Granville, M.D., from the Florida State University College of Medicine has developed an exercise where the cadaver is approached as a student's first patient. The "Anatomy Class: Introduction to the First Patient" guides instructors through the process of treating a venerable anatomy teaching tool as a patient. The purpose of this exercise is to apply clinical observation skills to the appearance of the cadaver, and to associate these clinical findings with the "anticipated impact on daily life."

Dr. Granville's product facilitates integration of patient exposure into the basic science curriculum of today's medical school experience. Treating a cadaver as a patient brings a clinical nature to dissection, treats a cadaver as a human being rather than a collection of bones and organs to be memorized, teaches students to have a critical eye in examinations without using technological aids or diagnostic procedures, and introduces the effects of the body's composition on critical aspects of an aging human's life and functioning.

This concise, two-page document describes the 35-40 minute exercise (divided between two sessions) by providing a time structure and bulleted descriptions of the student activities. With assistance from the gross anatomy lab teaching assistants and personnel, the students record their observations and hypotheses with the intention of providing an "Anatomy 'First Patient' Report" during a class following the anatomy segment (such as the Doctoring or Histology courses). These students' observations, recorded and displayed in PowerPoint format, are presented to classmates, clinical faculty, and basic science faculty. Based on the knowledge of the age, gender, and occupation of the cadaver, combined with their observation of the surface anatomy, thorax, back and spinal cord, upper extremity, abdomen, head, neck, pelvis, and lower extremity, student presentation groups are able to provide a reasonable hypothesis of the suspected cause of death and the probable functional ability before death.

Dr. Montross concludes in the piece that “the dissection of cadavers also gives young doctors an appreciation for the wonders of the human body in a way that no virtual image can match. It is awe-inspiring to hold a human heart in one’s hands, to appreciate its fragility, intricacy and strength. But most important, the cadavers on their stainless steel tables are symbols of altruism to medical students: They are reminders of how great a gift one can give to a stranger in the hopes of healing. Isn’t that the most fundamental lesson we want our doctors to carry to the bedsides of their patients?” This innovative approach to the basic science curriculum is a simple, refreshing, and exciting opportunity for medical students to begin honing their observation skills. This also acts as a dry run at assessing their first geriatric patient without the added element of social interaction. We hope that this provides yet another method of approaching anatomy in the classroom, as it expands clinical experience with older adults and provides an added dimension to the dissection of a cadaver. Download it today on www.POGOe.org!